Southwest Health & Housing Training

Jointly sponsored by Vanderbilt University School of Medicine and the National Health Care for the Homeless Council

Join colleagues from across the country for two full days of professional development at the National Health Care for the Homeless Council’s Southwest Health & Housing Training, October 28 – 29, 2013, in Houston. Register today for this exciting training that also offers networking opportunities for providers of health care and shelter services to special populations throughout Texas and the rest of Region VI.

The U.S. Census Bureau found in 2010 that 28.4 percent of American Indians and Alaska Natives live in poverty. By comparison, the U.S. population as a whole has a 15.3 percent poverty rate. Indigenous people are disproportionately represented among Americans experiencing homelessness. Unfortunately, there is a significant gap in our knowledge on the needs and challenges of indigenous populations who struggle with homelessness in urban, rural, and reservation settings. This introduction to housing and healthcare challenges affecting Native American Indian features Linda Son-Stone, CEO of First Nations Community HealthSource. Special population programs include services which enhance the physical, spiritual, emotional and mental well-being of Native American families and other underserved including homeless populations residing in Albuquerque, New Mexico and surrounding areas.

Medicaid expansion represents one of the biggest opportunities to improve the health and stability of individuals experiencing homelessness but half of states are currently refusing to take up this option. Texas represents the largest of these ‘non-expansion states’ with 1/4 of its population uninsured. The political realities in Texas make advocating for Medicaid expansion difficult, but the Health Care for the Homeless community has nonetheless been engaged at many levels to put pressure on policy makers to opt-in to Medicaid expansion. This presentation will provide an overview of the Medicaid expansion and its fiscal and social benefits for states, a description of the work done so far, and opportunities to get involved in the campaign in Texas. With members of the HCH community from all levels working in Texas, we can get to yes on Medicaid expansion.

Introduction to Special Populations Health: The New Face of Homelessness (45 minutes)

When homelessness was identified as a social problem brought to the forefront in the 80’s, the population primarily included those chronically homeless and was typically comprised of males and those affected by substance abuse and mental health issues. Today, there is a new face of homelessness; women and children. In 2009 the National Center on Family Homelessness reported 1.5 million children across the nation are experiencing homelessness on an annual basis. Unfortunately, in three short years this number has grown to 1.6 million children. The health challenges of this population are many. This session will identify the health challenges that impact this population and will share a unique program model that has demonstrated effectiveness at creatively addressing the health needs of this very vulnerable population.

Panel Discussion: Meeting Individual Needs

This moderated panel will bring together all of the presenters from the morning sessions, providing an opportunity for workshop participants to engage in deeper exploration and synthesis of topical threads and their application for healthcare delivery to special populations and sub-groups. It will set the framework for expanding the scope of the conversation in later sessions, from emphasis on individuals to community-level consideration.

Trauma Informed Care and THRIVE: Self Care (3 hours)

Recent research on the brain and trauma gives those working in the helping professions a new paradigm to conceptualize and work with clients. Understanding how trauma impacts brain development puts harmful behaviors and destructive thinking patterns in context, and gives helpers a roadmap for building relationships and promoting healing and growth. This training presents the Trauma Informed paradigm in a practical context, giving learners both a theoretical basis and tools to apply immediately to their work with clients. Through the application of this Trauma Informed paradigm workers can minimize re-traumatization while creating an environment for the traumatized individual to regain control of their lives.

In addition to focusing on effectively working with trauma in clients, this presentation will also focus on the health and effectiveness of the helper and the organization. Helping professionals are at risk of experiencing reactions that mirror those of the traumatized clients they serve. Research demonstrates the dangerous impact on physical and emotional health when exposure to trauma is combined with a stressful work environment. Knowledge is the best defense against burn-out, vicarious trauma and compassion fatigue.

Cultural Competency and Special Populations (3 hours)

Organizations are consistently challenged with implementing quality, evidence based programs and services that meet the needs of their targeted, yet diverse patient populations. Understanding the cultural elements that influence an individual’s beliefs surrounding health, healing, wellness, illness, disease, and the delivery of health services is key to the provision of patient centered care especially when working with specialized populations. This workshop is designed to help participants explore key principles of culturally competent care and service provision from both the clinical and administrative perspectives. Integrated activities and small group discussions will allow attendees to actively engage in identifying the cultural and linguistic needs of their localized target populations and explore ways to weave cultural competency into the various components of organizational and programmatic development.

Integrating HIV Care into Primary Care and Public Health: A Medical Home Model Approach (3 hours)

HIV increasingly affects underserved populations with complex health care, mental health and prevention needs. These populations benefit from integrated service delivery models care. The medical home model is a promising approach for fostering high quality, integrated care for patients with complex medical conditions, including HIV. This presentation will provide an overview of the medical home model, provide examples of how HIV prevention programs and services can be integrated into a medical home model and identify organizational change strategies that help ensure coordinated, patient-centered medical care.

Health Reform (45 minutes)

This discussion will highlight the key aspects of the Affordable Care Act that impact low-income populations and the options available to Texas to increase insurance access for its residents. Participants will hear from national and state representatives about the current status of Texas compared to others in the country, and engage in conversation about next steps that are needed to ensure better health and lower costs for both communities and families.

Presenter: Barbara DiPietro, PhD, Policy Director, National Health Care for the Homeless Council

Consumer Skill-Building: Strategies for Advancement (45 minutes)

This workshop will increase the professional and interpersonal aptitude of consumers involved on HCH CABs and other forms of consumer governance. Presenters will engage attendees through lecture and facilitated discussion. First, presenters will address the role of information technology in communication and knowledge development. Survey research is another topic – consumers at several HCH projects and NCAB leaders participate in survey projects, gathering information that supports development of better HCH programs and inter-organizational and public policy; this workshop demonstrates the role of the survey process in supporting HCH projects. HCH projects can benefit from consumer participation in proposal development and it is a process that can increase writing and strategic thinking skills among consumers. Finally, advocacy is an area that enables consumers to tap into their own experiences and develop greater confidence and comfort working with diverse crowds.

Presenter: Brian Zralek, MSSW, Consumer Advocate, National Health Care for the Homeless Council and Joseph Benson, Community Health Worker, Healthcare for the Homeless – Houston

Housing (45 minutes)

In this session, Dianna Grey, director of Corporation for Supportive Housing’s Texas program, will discuss models of permanent supportive housing being implemented in Texas communities. Using examples from Houston, Austin, Dallas, Fort Worth, and San Antonio, attendees will learn about diverse housing models, housing authority involvement, PSH targeted to special homeless populations, efforts to streamline access to VASH (Veterans Affairs Supportive Housing), and the service funding landscape.

Panel Discussion: Meeting the Needs of a Community

The theme for the discussion is “Meeting Need as a Community” and will focus on the strategies that providers and consumers can adopt to address needs for housing, Medicaid enrollment, and collaboration in order to achieve wide-ranging system improvements. Participants on this panel represent a wide range of views and experience, to include high level policymakers and frontline workers engaged directly with clients. We hope this discussion will unite various elements needed to meet community health and housing needs.

Outreach and Enrollment (3 hours)

The Affordable Care Act presents new tools and opportunities for engaging with the most vulnerable and disconnected members of our communities. By establishing a relationship with health care and social service providers, the ACA can help with getting a person’s foot in the door. However, these resources will be underutilized if we do not have outreach workers and health care professionals dedicated to going into the streets, shelters, and other service locations to find, engage, and enroll people into programs. This workshop will detail the efforts of outreach workers attempting to link people experiencing homelessness with medical insurance, health care options, and ongoing community support.

Leveraging Resources through Collaboration: Using Current Assets to Build Bridges (3 hours)

During times of dwindling resources and increased demand for comprehensive services, organizations are challenged with providing more programs and more services with fewer resources. For many organizations, collaborating with other agencies allows them to expand the array of services needed to meet increasing needs. This workshop will help participants think strategically about using collaborative partnerships to enhance care coordination, maximize community assets, and prevent service duplication in their communities. Participants in this workshop will explore the benefits of working collaboratively to increase the reach, efficiency, and impact of their services.

During this interactive workshop, participants will identify current assets and potential resources in their local communities and explore methods to build sustainable, mutually beneficial relationships with potential community partners. Participants will also utilize illustrative cases and planning tools to identify goals of collaborative efforts, barriers to collaboration and mitigation strategies to overcome those barriers.

Emergency Preparedness and Disaster Planning (3 hours)

Families and individuals experiencing homelessness are often more severely impacted by disasters than other members of the community. When disasters strike, people experiencing homelessness are at particular risk of harm and their providers are often not prepared to meet their needs in the immediate aftermath. Additionally, the homeless sector often lacks critical resources both systemically and individually to prepare for the absence of services for a period of days after a disaster. During this interactive half-day workshop, attendees will discuss strategies for addressing a number of issues that impact people experiencing homelessness during disasters.

The workshop will begin with a partial showing of the documentary, Tent City, USA. Tent City, USA explores the communal life of the residents of Tent City, Nashville’s largest homeless encampment, in the weeks preceding and following one of Nashville’s most devastating floods. The documentary highlights the struggles of Tent City residents as they attempted to escape rising waters and their challenges in accessing recovery services. Topics for discussion include: homeless encampments located in flood plains, risk assessments and mitigation, preparedness activities targeted to homeless populations, integrating homeless populations and services in emergency shelters (e.g., Red Cross shelters), improving communication and coordination among homeless service providers, and improving access to recovery resources.

This workshop is appropriate for frontline workers and administrators from homeless service agencies, first responders, emergency planners, people who have experienced homelessness, and others interested in the health and safety of people experiencing homelessness. We encourage a wide range of participants in this session in order to learn from diverse perspectives.

Presenters: Sabrina Edgington, MSSW, Program and Policy Specialist, National Health Care for the Homeless Council; David Canavan, Canavan Associates

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U30CS09746, a National Training and Technical Assistance Cooperative Agreement for $1,625,741, with 0% match from nongovernmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.